6 posts from November 2014

11/21/2014

Depression is a mental disorder that has an unknown cause. There are many explanations for developing depression including genetic, biological, environmental, and psychological features. Signs and symptoms of depression vary from minimal to severe. Indication that someone may need medication to regulate his or her mood include the following symptoms: persistent sadness, hopelessness, fatigue, irritable mood, loss of interest, feelings of guilt, difficulty concentrating, insomnia, and suicidal thoughts.

There are a variety of classes of medications used for depression, but they all need to be given an adequate trial of about twelve weeks to see if the medication is efficacious. Roughly fifty percent of patients prematurely discontinue antidepressant therapy. There are serious outcomes if medication is not taken including suicide. A systemic review by Chong evaluated the impact of education and behavioral interventions on antidepressant medication adherence and depression disease progression. This review showed patient education alone did not improve medication adherence rates; however, when used with behavioral changes and multifaceted interventions, adherence rates and depression outcomes improved. Behavioral and multifaceted interventions include education, telephone follow-up, medication support, and communication with primary care providers. For this reason, it is crucial to have pharmacist intervention when dealing with antidepressants to provide proper counseling on the medication to lead to better insight on the medication as well as intervene on proper behavioral changes.

Pharmacists canhelp increase outcomes of depressed patients by counseling them on their medication. Antidepressants are different than other medications because they need a longer period of time to feel it working. This presents as an issue for patients because they do not feel the need to take a medication that is not helping them feel better instantaneously. Also, patients might think they do not need a medication if they are starting to feel better. Pharmacists should explain to the patient that it takes antidepressants at least two weeks to take effect. Patients should also be informed that there are common side effects associated with these medications and it is important to continue taking antidepressants for at least six to nine months to prevent reoccurrence of depression.

Because there are many negative side effects of depression, it is important to manage it with appropriate medications. Due to their expertise on antidepressants, pharmacists can counsel patients on what to expect, the onset of action, and duration of use for these medications. Through patient education, behavioral changes, and multifaceted interventions patients can have better outcomes for their depression.

11/18/2014

Those fortunate enough to be somewhere warm during this recent cold snap might wonder how Philadelphia’s homeless population can survive the frigid outdoor conditions, said Stephen Metraux, PhD, associate professor of health policy and public health at University of the Sciences.

“Data on how many homeless are stuck out in the cold is difficult to come by,” said Dr. Metraux. “The homeless population is notoriously challenging to count, as they usually strive to stay inconspicuous amidst the public spaces to which they are relegated.”

The best available number comes from the City of Philadelphia’s annual “Point in Time” count, when teams of volunteers canvass the shelters and streets and count the number of homeless people and families that they encounter. Of the estimated 5,500 homeless individuals counted on a January night in 2013, 388 of them were unsheltered. That figure is down from the 526 individuals recorded on a January night in 2012.

So how do these hundreds of homeless individuals survive below-freezing conditions? The first line of defense is provided by the City of Philadelphia, which implements a “Code Blue” on any night when temperatures fall under or hover around 20 degrees, said Dr. Metraux.

On Code Blue nights, outreach workers and police can bring in any homeless person to stay in a shelter or other public facility temporarily designated for overnight accommodations. No one gets turned away and, if necessary, a Court Ordered Transportation to Shelter can be quickly obtained to bring resistant individuals indoors on occasions when leaving a person outdoors may subject him or her to danger from the cold weather elements.

“Code Blue’s success is best indicated by the rarity of hypothermia deaths among homeless persons in the past few years,” said Dr. Metraux. “But Code Blue is at best a stopgap solution; the best solution for protecting the homeless from the elements is through renewed efforts to reduce homelessness.”

The number of homeless people living on the streets across Philadelphia has been declining over the previous few years, due largely to innovative programs that engage the most recalcitrant homeless persons and provide them with housing and services, he said.

11/12/2014

Hypertension, also known as high blood pressure, does not usually present itself with symptoms. However, it can be deadly if not treated properly. Through time, 78 million Americans have been diagnosed with hypertension. High blood pressure occurs when the force of blood is high causing the arteries to stretch and damage, which can lead to severe complications such as heart attacks. To prevent cardiovascular events, it is important to chronically treat hypertension. With increasing number of patients getting this disease, it is key for patients to stay educated, monitor blood pressure, and adherent to their diet and medication regimen.

According to the Health Belief Model (HBM), there are certain aspects that tell whether a patient will take their medications. Some barriers to adherence include patients perceived susceptibility and severity of the disease. If patients do not think they are going to get a disease or the disease does not impact their quality of life, they may not be adherent to medications. Patients have a call to action, such as taking medications and staying adherent, when there is a perceived threat of the disease. Another hindrance of medication adherence would be the patient’s perceived benefits of taking medications minus the barriers or side effects that comes along with it. This HBM can help pharmacists understand patient non-adherence and allow them to better approach to medication therapy management.

A systematic review in the Health Psychology Review by Jones identified intervention studies used by the health belief model. From 18 studies evaluated, 78% of the studies suggested significant improvements in adherence with behavior change interventions. The health belief model is a way to promote behavior through interventions in a variety of disease. The HBM can be applied to hypertension through the help of pharmacists. Researching how much education patients have about the disease will allow pharmacists to gauge how well patients understand the disease. Knowledge of the disease can be assessed through questionnaires. Through these surveys, pharmacists can learn about the patient’s lifestyle to construct the best regimen.

The prevalence of hypertension will decrease dramatically when pharmacists incorporate the HBM into counseling patients. By understanding the HBM, our society can better the symptoms of hypertension.

11/10/2014

A team of eight student-pharmacists from University of the Sciences joined more than 150 new volunteers with the Philadelphia Medical Reserve Corps as they acted out a bioterrorist attack which required them to administer antibiotics to thousands of Philadelphians to help prevent the spread of a deadly bacterial infection.

This dramatic, but informational, training session was held at USciences on Saturday, Nov. 8, for these credentialed volunteers – who are typically seen providing medical care and first aid after major storms, or at large city events such as the Philadelphia Marathon.

“Bringing together such a diverse group of local healthcare professionals and students was a positive experience which reinforced USciences’ mission of promoting integrated learning and professionalism,” said Steven Sheaffer, PharmD, associate professor of clinical pharmacy.

Although Dr. Sheaffer has been a member of the Medical Reserve Corps since 2007, he said regularly attends training sessions to keep up to speed with relief efforts and build stronger relationships with healthcare professionals across the Philadelphia region.

“I hope that more of our students across all disciplines consider attending future training programs and join the Medical Reserve Corps,” he said.

Aside from USciences pharmacy students and faculty, other volunteers at the training session included medical and doctoral students from University of Pennsylvania, nurses, as well as students and faculty from other local universities.

The Sept. 11, 2001, terrorist attacks on the World Trade Center and the mailing of anthrax-tainted letters to news media and U.S. senators painfully illustrated the need for more organized use of medical volunteers.

The Philadelphia Department of Public Health launched the city’s unit in 2005, after Congress allocated money to establish the Medical Reserve Corps program office in the U.S. Surgeon General’s Office. Philadelphia’s chapter now boasts more than 1,800 volunteers who offer their medical, pharmaceutical, behavioral health, and other skills.

“I wanted to volunteer for the medical corps to use my pharmacy education in way that allows me to give back to the community,” said Alex Fevry PharmD’17.

11/04/2014

As a fifth-year pharmacy student, I can say my experience at University of the Sciences has equipped me well in pursuing my goals. The pharmacy field appealed to me because it combined my interests of science and helping others. During high school and early college years, I was hesitant to hold leadership positions; however, in my third year, I decided to run for presidency of Circle K, the community service organization on campus. A majority of students at USciences will enter careers where they will be helping patients every day. I believed providing students with opportunities to help and interact with those in the Philadelphia community would serve as a jumpstart to their careers.

As Circle K president, I delegated tasks to the various executive board (e-board) members and followed up to completion. Establishing timelines and assigning tasks based off members’ strengths was essential. Additionally, constant communication and considering input from all members attributed to the success of the various events.

Circle K was involved volunteering at fundraisers and walks, canned food drives, and creating decorations for the Children’s Hospital of Philadelphia. We also volunteered with the HMS School for Children with Cerebral Palsy during holidays. A personal favorite of many students and mine was the Making Strides Against Breast Cancer event. Approximately 20 students attended the walk and interacted with breast cancer survivors and their families. Our group participated in volunteering with registration, handing out drinks and snacks to runners, and preparing gift bags for survivors. Several students stated that this was one of their favorite experiences at USciences thus far, and I was happy that Circle K was able to coordinate this event.

I gained skills such as time management, problem solving, communication, and delegation as Circle K President. This leadership position was the foundation for my involvement in other organizations on campus such as PCP Student Council, American Pharmacist’s Association, as well as off-campus experiences. The skills and experiences as president of an organization are invaluable and will be utilized throughout my remaining years at USciences, as well as my career. A suggestion to all, do not hesitate to get involved on campus. A leadership position is not only educational, but also enjoyable and rewarding. It will help you reach your full potential no matter what career path you choose.

“Basically, my new book tells the story of how the friendship between Einstein and Schrodinger developed through their mutual dislike of quantum uncertainty, flourished as they sought a ‘theory of everything,’ and then crumbled during an international media fiasco,” said Dr. Halpern.

Dr. Halpern said that Albert Einstein and Erwin Schrödinger were friends and comrades-in-arms against what they considered the most preposterous aspects of quantum physics: its indeterminacy. Even though it was Einstein’s own theories that made quantum mechanics possible, both he and Schrödinger could not bear the idea that the universe was, at its most fundamental level, random.

Here’s an excerpt from the book’s description:

“Einstein famously quipped that God does not play dice with the universe, and Schrödinger is equally well known for his thought experiment about the cat in the box who ends up "spread out" in a probabilistic state, neither wholly alive nor wholly dead. Both of these famous images arose from these two men's dissatisfaction with quantum weirdness and with their assertion that underneath it all, there must be some essentially deterministic world. Even though it was Einstein's own theories that made quantum mechanics possible, both he and Schrödinger could not bear the idea that the universe was, at its most fundamental level, random.

“As the Second World War raged, both men struggled to produce a theory that would describe in full the universe's ultimate design, first as collaborators, then as competitors. They both ultimately failed in their search for a Theory of Everything—not only because quantum mechanics is true, but because Einstein and Schrödinger were also missing a key component: of the four forces we recognize today (gravity, electromagnetism, the weak force, and the strong force), only gravity and electromagnetism were known at the time.

“Despite their failures, though, much of modern physics remains focused on the search for a Theory of Everything. As Halpern explains, the recent discovery of the Higgs Boson makes the Standard Model—the closest thing we have to a unified theory—nearly complete. And while Einstein and Schrödinger tried and failed to explain everything in the cosmos through pure geometry, the development of string theory has, in its own quantum way, brought this idea back into vogue. As in so many things, even when he was wrong, Einstein couldn't help but be right.”

Dr. Halpern is the recipient of a Guggenheim Fellowship, a Fulbright Scholarship, and an Athenaeum Literary Award. He has also appeared on numerous radio and television shows including Future Quest, Radio Times, several shows on the History Channel, and The Simpsons 20th Anniversary Special.

For more information regarding Dr. Halpern’s new book, or to make a purchase, click here.